常规剂量替罗非班联合半剂量瑞替普酶治疗ST段抬高性急性心肌梗死的疗效观察

Clinical observation of conventional dose of tirofiban combined with semi-dose of reteplase on treatment of ST elevation acute myocardial infarction

目的探讨常规剂量替罗非班联合半剂量瑞替普酶治疗ST段抬高性急性心肌梗死的溶栓效果及安全性。方法选取ST段抬高性急性心肌梗死患者100例,随机分为观察组和对照组,各50例,对照组采用瑞替普酶进行治疗,观察组在常规剂量替罗非班的基础上联合半剂量瑞替普酶治疗,对比2组溶栓效果、NIHSS评分并记录出血情况及并发症。结果用药后,对照组和观察组总再通率分别为64%(32/50)、86%(43/50);观察组治疗后NIHSS评分相较治疗前明显降低,差异有统计学意义(P<0.05);对照组非致死性心肌再梗死发生率、室性心动过速、肺水肿、心肌缺血等发生率明显高于观察组(P<0.05)。结论替罗非班联合半剂量瑞替普酶治疗ST段抬高性急性心肌梗死,可达到较好的溶栓效果,用药风险降低,具有非常重要的联合应用价值。

Objective To explore the thrombolytic effect and safety of conventional dose of tirofiban combined with semi-dose of reteplase for treating ST elevation acute myocardial infarction.Methods Totally 100 patients with ST elevation acute myocardial infarction were selected and randomly divided into observation group and control group,50 cases in each group. Patients in control group were treated with reteplase while patients in observation group were treated with conventional dose of tirofiban combined with semi-dose of reteplase. The thrombolytic effect,NIHSS score,bleeding condition and complications were recorded and compared. Results After treatment,the reperfusion rates of two groups were 64%（ 32 /50） and 86%（ 43 /50） respectively,and there was statistical difference between them（ P〈0.05）. NIHSS score was lower after treatment than treatment before in observation group（ P〈0.05）. The occurrence rates of nonfatal myocardial infarction,ventricular tachycardia,pulmonary edema and myocardial ischemia were higher in control group than those in observation group（ P〈0.05）. Conclusion Conventional dose of tirofiban combined with semi-dose of reteplase for treating ST elevation acute myocardial infarction can achieve better thrombolytic effect,and reduce the risk of drug use,so the joint application value of them is relatively high.